Sound waves could significantly improve sexual activity in men whose severe erectile dysfunction has not responded well to drug treatments, a new study has found.
Researchers employed a technique similar to that used to break up kidney stones to shock the penis into life with low-intensity waves.
So-called 'extracorporeal shock wave therapy' has been found to improve blood flow to the heart by inducing blood vessel growth, so experts speculated that such waves might also improve circulation to the penis.
An earlier study showed shock wave therapy benefited men with mild to moderate erectile dysfunction (ED).
But the new study's findings suggest the therapy could also be used to treat ED patients who don't respond well to conventional treatment.
However, the study was small, involving only 29 men, and the results may have been due to a placebo effect, so more work is needed to validate the findings, the researchers said.
Participants filled out a questionnaire to assess their sexual function.
Scores ranged from six to 30 - with ratings lower than 10 indicating severe ED and those from 26 to 30 indicating normal erectile function.
The men, whose average age was 61, were given 300 shocks over a period of three minutes on five points along the shaft of the penis during each session.
There were two sessions per week for three weeks, then three weeks off, and then another three-week treatment period. No men reported pain or adverse side-effects during treatment.
Participants began taking ED drugs one month after the last treatment.
The average score at the beginning of the study was 8.8. Two months after the treatment stopped, the average increased 10 points.
For many men, this means the difference between being able and being unable to have sex said study researcher Ilan Gruenwald, associate director of the neuro-urology unit at the Rambam Medical Center in Haifa, Israel.
Eight men achieved normal sexual function.
On average, men started to see a benefit three weeks after treatment.
Dr Andrew Kramer, a urologist at the University of Maryland Medical Center, who was not involved in the study, said the results were counter-intuitive given that sound waves used in kidney stone treatments are designed to be destructive.
'It's like saying, take your penis and hit it with a hammer a couple of times,' Kramer said.
The researchers acknowledged their work is preliminary, but, given their results, they said they hope others in their field remain open-minded about the therapy.
The study was published online October 18 in the Journal of Sexual Medicine.
2011年10月31日星期一
2011年10月30日星期日
`Shock therapy may improve erectile dysfunction`
Good news for those suffering from sever sexual impotence -- scientists have developed a new shock wave therapy which they say could significantly benefit
people who don`t respond well to conventional therapies.
A team at Rambam Healthcare Campus in Haifa who carried out the "extracorporeal shock wave therapy" on 29 men with sever erectile dysfunction (ED) found that the technique significantly improved their sexual function.
The patients in the study continued to see improvements two months after the treatment had stopped, and close to 30 per cent of them achieved normal sexual function and no longer required medications, LiveScience reported.
Extracorporeal shock waves have been used to break up kidney stones, but the sound waves used in the study to treat ED were much less intense and no men reported pain or adverse events during the treatment, the researchers said.
The results, published in the Journal of Sexual Medicine, suggest that sound wave therapy may used to treat ED patients who don`t respond well to conventional therapies, they said.
However, the researchers said, the study was small and the results could have been a placebo effect, so more work is needed to validate the findings.
In the study, the participants, aged over 60, underwent 12 shock treatments over nine weeks. One month after the last treatment, participants began taking ED drugs.
Two months after the treatments concluded, the ED scores improved in 75 per cent of the men in the study. Eight men, nearly 30 per cent, had erections in the normal range when
they used an ED pill. Blood flow improved in all the men.
"For many men, this means the difference between being able and being unable to achieve vaginal penetration," said study researcher Ilan Gruenwald, an associate director of the neuro-urology unit at the Medical Center.
However, other experts have expressed doubts over the success of the the therapy.
The results of the study are somewhat counterintuitive, considering that sound waves used in kidney stone treatments are designed to be destructive, said Dr Andrew Kramer, a
urologist at the University of Maryland Medical Center, who was not involved in the study.
"It`s like saying, take your penis and hit it with a hammer a couple of times," Kramer said.
Even if the benefits of extracorporeal shock wave therapy are confirmed by future research, the therapy may never be mainstream, Kramer said. For one reason, it requires a special machine.
The researchers acknowledged their work is preliminary, but, given their results, they said they hope others in their field remain open-minded about the therapy.
people who don`t respond well to conventional therapies.
A team at Rambam Healthcare Campus in Haifa who carried out the "extracorporeal shock wave therapy" on 29 men with sever erectile dysfunction (ED) found that the technique significantly improved their sexual function.
The patients in the study continued to see improvements two months after the treatment had stopped, and close to 30 per cent of them achieved normal sexual function and no longer required medications, LiveScience reported.
Extracorporeal shock waves have been used to break up kidney stones, but the sound waves used in the study to treat ED were much less intense and no men reported pain or adverse events during the treatment, the researchers said.
The results, published in the Journal of Sexual Medicine, suggest that sound wave therapy may used to treat ED patients who don`t respond well to conventional therapies, they said.
However, the researchers said, the study was small and the results could have been a placebo effect, so more work is needed to validate the findings.
In the study, the participants, aged over 60, underwent 12 shock treatments over nine weeks. One month after the last treatment, participants began taking ED drugs.
Two months after the treatments concluded, the ED scores improved in 75 per cent of the men in the study. Eight men, nearly 30 per cent, had erections in the normal range when
they used an ED pill. Blood flow improved in all the men.
"For many men, this means the difference between being able and being unable to achieve vaginal penetration," said study researcher Ilan Gruenwald, an associate director of the neuro-urology unit at the Medical Center.
However, other experts have expressed doubts over the success of the the therapy.
The results of the study are somewhat counterintuitive, considering that sound waves used in kidney stone treatments are designed to be destructive, said Dr Andrew Kramer, a
urologist at the University of Maryland Medical Center, who was not involved in the study.
"It`s like saying, take your penis and hit it with a hammer a couple of times," Kramer said.
Even if the benefits of extracorporeal shock wave therapy are confirmed by future research, the therapy may never be mainstream, Kramer said. For one reason, it requires a special machine.
The researchers acknowledged their work is preliminary, but, given their results, they said they hope others in their field remain open-minded about the therapy.
2011年10月27日星期四
Donor dads are meeting in Toronto
Two fathers who live worlds apart — one in the West Bank, the other in California — are meeting in Toronto for the first time this weekend.
The lives of Ismael Khatib, 45, a mechanic, and Reg Green, 82, a journalist, couldn’t be more different. And yet they are bound by a life-altering experience. They both lost their young sons to a gunman’s bullets. And they both allowed their dying children’s organs and tissue to be harvested for transplants.
As a result of two violent deaths — and the generosity of two grieving families — 11 lives were saved. Another two people regained their sight.
Khatib and Green are coming here for a 10-day mission to encourage Canadians to sign donor cards. At a more personal level, they are making the long trek to Canada to honour Ahmed, who was 11 when he died in 2005, and Nicholas, who was 7 when his life ended in 1994.
Their schedule will include a visit to Toronto General Hospital, walks in memory of the boys and organ and tissue donation drives in Toronto, Ottawa and Montreal from Oct. 29 to Nov. 7. The donor dads may take in a Maple Leaf game.
On Monday, with the support of MPPs from all parties, Conservative Frank Klees will introduce a bill to create an alert system, much like the Amber Alert, for children under 18 in urgent need of an organ or tissue transplant.
In a recent telephone interview with the Star, Green spoke enthusiastically about his meeting with Khatib. “There is a common thread of giving across a barrier in both his case and ours,” says Green.
The two men have conversed on Skype. Khatib, in a telephone interview from the West Bank, said the face-to-face meeting will bring a measure of good out of tragedy. “Meeting him will increase my conviction that what I did was right,” Khatib said through an interpreter.
Canada is the venue for Green and Kahtib’s first meeting because of the efforts of George Marcello, 56, who received liver transplants in 1995 and 2005. His health challenges have led him to devote himself full-time to fundraising and public-awareness campaigns.
It is Marcello who felt that bringing Green and Khatib to Canada would highlight the role that donors can play and go a long way to improving the dismal sign-up rate in Ontario. A former fitness trainer, he has organized walks through Ontario and across Canada through Step by Step, the charity he runs from his modest home in Little Italy that his parents left him and his siblings. His Torch of Life was blessed by Pope John Paul II in 2001 and has now been carried by children in rallies throughout Canada, the U.S. and Italy.
The visits of the two men are being made possible with help from the National Congress of Italian Canadians, the Canadian Peres Centre for Peace, Step by Step, Iman Ali Roukieh of the Muslim Girls School and several others, including Dr. Izzeldin Abuelaish, the Palestinian doctor whose three daughters and a niece were killed in the Gaza Strip by Israeli shelling.
Here are the stories of Nicholas and Ahmed.
Nicholas Green died on Oct. 1, 1994. Seven-year-old Nicholas, his parents, Reg and Maggie, and his sister, Eleanor, 4, were on a European holiday that had started in Switzerland a week before.
Late one night, as they drove down the highway from Naples to Sicily, a car raced up beside them. The two occupants shouted and gestured for Green to pull over. Sensing danger, he accelerated.
“The two cars raced beside each other,” Green said in a recent conversation from his home in La Canada, California. “Then there was a tremendous explosion and the window behind the driver’s window, where the two kids were sleeping, was blown in. A moment later the driver’s window was blown in.”
The car dropped back and disappeared.
Reg and Maggie, in the front seat, were frantic. Maggie looked back; both children seemed to be asleep. Reg sped down the road hoping to get help. About 15 kilometres along they came upon police and ambulances at another accident scene. Reg pulled over, and the extent of Nicholas’s injury became evident.
“When I opened the car door, the interior light came on and Nicholas didn’t move.” He looked closer and saw that the boy’s tongue was sticking out unnaturally. “I had been a journalist long enough to know that was a very bad sign.”
He had been shot in the base of the brain.
Two days later, the doctors told Reg and Maggie that they couldn’t save Nicholas. He was brain dead.
It was Maggie who asked doctors whether organs and tissue from their “magical little child” could be used for transplant.
Reg recreates that terrible moment: “I remember thinking, ‘How are we going to get through the rest of our lives without him?’ But then suddenly there was this possibility that somebody could benefit from this. There was that sense that, although he didn’t need that body any more there were a lot of people out there who desperately needed what that body could give.”
The lives of Ismael Khatib, 45, a mechanic, and Reg Green, 82, a journalist, couldn’t be more different. And yet they are bound by a life-altering experience. They both lost their young sons to a gunman’s bullets. And they both allowed their dying children’s organs and tissue to be harvested for transplants.
As a result of two violent deaths — and the generosity of two grieving families — 11 lives were saved. Another two people regained their sight.
Khatib and Green are coming here for a 10-day mission to encourage Canadians to sign donor cards. At a more personal level, they are making the long trek to Canada to honour Ahmed, who was 11 when he died in 2005, and Nicholas, who was 7 when his life ended in 1994.
Their schedule will include a visit to Toronto General Hospital, walks in memory of the boys and organ and tissue donation drives in Toronto, Ottawa and Montreal from Oct. 29 to Nov. 7. The donor dads may take in a Maple Leaf game.
On Monday, with the support of MPPs from all parties, Conservative Frank Klees will introduce a bill to create an alert system, much like the Amber Alert, for children under 18 in urgent need of an organ or tissue transplant.
In a recent telephone interview with the Star, Green spoke enthusiastically about his meeting with Khatib. “There is a common thread of giving across a barrier in both his case and ours,” says Green.
The two men have conversed on Skype. Khatib, in a telephone interview from the West Bank, said the face-to-face meeting will bring a measure of good out of tragedy. “Meeting him will increase my conviction that what I did was right,” Khatib said through an interpreter.
Canada is the venue for Green and Kahtib’s first meeting because of the efforts of George Marcello, 56, who received liver transplants in 1995 and 2005. His health challenges have led him to devote himself full-time to fundraising and public-awareness campaigns.
It is Marcello who felt that bringing Green and Khatib to Canada would highlight the role that donors can play and go a long way to improving the dismal sign-up rate in Ontario. A former fitness trainer, he has organized walks through Ontario and across Canada through Step by Step, the charity he runs from his modest home in Little Italy that his parents left him and his siblings. His Torch of Life was blessed by Pope John Paul II in 2001 and has now been carried by children in rallies throughout Canada, the U.S. and Italy.
The visits of the two men are being made possible with help from the National Congress of Italian Canadians, the Canadian Peres Centre for Peace, Step by Step, Iman Ali Roukieh of the Muslim Girls School and several others, including Dr. Izzeldin Abuelaish, the Palestinian doctor whose three daughters and a niece were killed in the Gaza Strip by Israeli shelling.
Here are the stories of Nicholas and Ahmed.
Nicholas Green died on Oct. 1, 1994. Seven-year-old Nicholas, his parents, Reg and Maggie, and his sister, Eleanor, 4, were on a European holiday that had started in Switzerland a week before.
Late one night, as they drove down the highway from Naples to Sicily, a car raced up beside them. The two occupants shouted and gestured for Green to pull over. Sensing danger, he accelerated.
“The two cars raced beside each other,” Green said in a recent conversation from his home in La Canada, California. “Then there was a tremendous explosion and the window behind the driver’s window, where the two kids were sleeping, was blown in. A moment later the driver’s window was blown in.”
The car dropped back and disappeared.
Reg and Maggie, in the front seat, were frantic. Maggie looked back; both children seemed to be asleep. Reg sped down the road hoping to get help. About 15 kilometres along they came upon police and ambulances at another accident scene. Reg pulled over, and the extent of Nicholas’s injury became evident.
“When I opened the car door, the interior light came on and Nicholas didn’t move.” He looked closer and saw that the boy’s tongue was sticking out unnaturally. “I had been a journalist long enough to know that was a very bad sign.”
He had been shot in the base of the brain.
Two days later, the doctors told Reg and Maggie that they couldn’t save Nicholas. He was brain dead.
It was Maggie who asked doctors whether organs and tissue from their “magical little child” could be used for transplant.
Reg recreates that terrible moment: “I remember thinking, ‘How are we going to get through the rest of our lives without him?’ But then suddenly there was this possibility that somebody could benefit from this. There was that sense that, although he didn’t need that body any more there were a lot of people out there who desperately needed what that body could give.”
2011年10月26日星期三
Energy Drinks Give You Wings...and Kidney Stones
In these current times, energy drinks are very common among people of all ages, especially teenagers. We have personal experience with drinking energy drinks, Red Bull specifically, and we know that there can be serious side effects of drinking a lot of such drinks. Lately, there have been more and more problems with the consumption of energy drinks; people passing out or committing crimes when exceeding the recommended amount of these drinks. For example, read the back of any Monster Energy Drink can, and you will find the warning statement cautioning you to not exceed three cans a day. Yet people ignore these warnings, and drink whatever they want, and however much they want of it.
Sarah Gurley, a phlebotomist at Mee Memorial Hospital, has had experience with teenagers coming into the hospital from consuming too many energy drinks. Gurley says, “I’ve seen an increase in young kids with cases of kidney stones related to energy drinks as the main problem.” Not only can you get painful kidney stones (which are like sharp grains of sand traveling through your body) as a side effect, but energy drinks also cause liver problems that are similar to those of alcoholics.
We drink Red Bull constantly, almost on a daily basis. It tastes amazing, makes us feel better, and it even claims to “give you wings.” But both of us have had issues with drinking too much of it and having too much caffeine in our bodies to be healthy. But now we’re smarter about drinking Red Bull; yes, we still drink it a lot, probably too much, but we know if we need to stop because we are informed of the consequences. So next time you drink Red Bull, or Rockstar or Monster, ask yourself this: do you know how much is too
Sarah Gurley, a phlebotomist at Mee Memorial Hospital, has had experience with teenagers coming into the hospital from consuming too many energy drinks. Gurley says, “I’ve seen an increase in young kids with cases of kidney stones related to energy drinks as the main problem.” Not only can you get painful kidney stones (which are like sharp grains of sand traveling through your body) as a side effect, but energy drinks also cause liver problems that are similar to those of alcoholics.
We drink Red Bull constantly, almost on a daily basis. It tastes amazing, makes us feel better, and it even claims to “give you wings.” But both of us have had issues with drinking too much of it and having too much caffeine in our bodies to be healthy. But now we’re smarter about drinking Red Bull; yes, we still drink it a lot, probably too much, but we know if we need to stop because we are informed of the consequences. So next time you drink Red Bull, or Rockstar or Monster, ask yourself this: do you know how much is too
2011年10月25日星期二
Kidney Pain!
Kidney stones are well-known to be one of the most painful experiences that we experience. For those who’ve been through it, it is compared to the pain of child birth. This short article will cover some kidney stone pain symptoms and what to look out for.Kidney stones pain signs and symptoms, in the more mild cases, could be inconvenient. In the much more serious cases, they can require surgery to remove, with enough pain to induce nausea or vomiting.
Initially, kidney stones had been known as the “silent stones”, because they don’t produce symptoms in the onset of forming. However, as the stones grow in size, they can trigger pain simply because they become much more difficult to pass. When the pain shows a pattern, and all other causes are ruled out, the remedy for kidney stones can start. Kidney stone pain signs and symptoms can consist of pain in the side, groin or lower back. Once the pain is not started by the position the person is sitting in, or by the position the individual moves to, as he or she looks for relief, this pain can be a symptom of kidney stones. The level of pain from these signs and symptoms can grow and recede in intensity.
Other kidney stone pain signs and symptoms which may be present can include painful urination, traces of blood in the urine, or an urgent feeling to go when it is not necessary. For men, there can also be testicular pain and penile pain. In the event the individual has developed an infection within the urinary tract, with the kidney stone, there might be chills or fever that accompany the pain. The good news is that most people have the ability to pass a kidney stone in 24-48 hours, with a large consumption of fluid.
Also, you will find remedies for your pain, as the stone is being passed. These treatments can include over-the-counter medicines. In the event the kidney stone pain signs and symptoms aren’t handled with the over-the-counter medicines, patients can ask their doctors for doctor prescribed narcotics or intravenous prescription medicines, if the person is nauseated or is prone to vomiting. For all those that are having much more difficulty passing the stone or stones, you will find choices available for them. Kidney stone pain signs and symptoms could be managed with prescription narcotics while other medicines are now being administered to help the stone or stones pass more rapidly.
For people that have kidney stones which will not pass on their very own, the procedure, lithotripsy is used. Lithotripsy is a process that utilizes shock waves to break up stones so that they can pass. Kidney stone pain signs and symptoms should abate after this procedure, because it breaks down the stones that are causing the pain, to help them pass much more rapidly. For much more extreme cases, you will find a couple of surgical methods that may be used to get rid of the stones and the pain.Kidney stone pain signs and symptoms can be handled in a variety of ways which will help the patient manage the pain, or eliminate the cause.
With advances in technologies, these “silent stones” could be dealt with quickly to get rid of the pain they cause for good. Kidney stone pain symptoms no longer need to be endured for long periods of time. Everything can be done quickly and efficiently to end the suffering kidney stones can cause.
Initially, kidney stones had been known as the “silent stones”, because they don’t produce symptoms in the onset of forming. However, as the stones grow in size, they can trigger pain simply because they become much more difficult to pass. When the pain shows a pattern, and all other causes are ruled out, the remedy for kidney stones can start. Kidney stone pain signs and symptoms can consist of pain in the side, groin or lower back. Once the pain is not started by the position the person is sitting in, or by the position the individual moves to, as he or she looks for relief, this pain can be a symptom of kidney stones. The level of pain from these signs and symptoms can grow and recede in intensity.
Other kidney stone pain signs and symptoms which may be present can include painful urination, traces of blood in the urine, or an urgent feeling to go when it is not necessary. For men, there can also be testicular pain and penile pain. In the event the individual has developed an infection within the urinary tract, with the kidney stone, there might be chills or fever that accompany the pain. The good news is that most people have the ability to pass a kidney stone in 24-48 hours, with a large consumption of fluid.
Also, you will find remedies for your pain, as the stone is being passed. These treatments can include over-the-counter medicines. In the event the kidney stone pain signs and symptoms aren’t handled with the over-the-counter medicines, patients can ask their doctors for doctor prescribed narcotics or intravenous prescription medicines, if the person is nauseated or is prone to vomiting. For all those that are having much more difficulty passing the stone or stones, you will find choices available for them. Kidney stone pain signs and symptoms could be managed with prescription narcotics while other medicines are now being administered to help the stone or stones pass more rapidly.
For people that have kidney stones which will not pass on their very own, the procedure, lithotripsy is used. Lithotripsy is a process that utilizes shock waves to break up stones so that they can pass. Kidney stone pain signs and symptoms should abate after this procedure, because it breaks down the stones that are causing the pain, to help them pass much more rapidly. For much more extreme cases, you will find a couple of surgical methods that may be used to get rid of the stones and the pain.Kidney stone pain signs and symptoms can be handled in a variety of ways which will help the patient manage the pain, or eliminate the cause.
With advances in technologies, these “silent stones” could be dealt with quickly to get rid of the pain they cause for good. Kidney stone pain symptoms no longer need to be endured for long periods of time. Everything can be done quickly and efficiently to end the suffering kidney stones can cause.
2011年10月24日星期一
Is This the End of Popping Vitamins?
A succession of large-scale human studies, including two published earlier this month in leading medical journals, suggests that multivitamins and many other dietary supplements often don't have health benefits—and in some cases may even cause harm.
The data have prompted some nutrition researchers to say taking vitamins is a waste of money for those without a specific nutrient deficiency or chronic illness. Such findings have also fueled a debate about whether the field should continue conducting expensive human trials to figure out whether particular supplements affect health.
"The better the quality of the research, the less benefit [supplements] showed," says Marion Nestle, professor of nutrition, food studies, and public health at New York University. "It's fair to say from the research that supplements don't make healthy people healthier."
For instance, vitamins B-6 and B-12 are often touted as being good for the heart, but several studies have failed to find that they lower risk of cardiovascular disease, according the Office of Dietary Supplements, part of the National Institutes of Health. Vitamin C hasn't been shown in many studies to lower a person's risk of getting a cold. Calcium, while important to bone health, doesn't lower risk of heart disease or cancer and may increase risk of kidney stones.
"We have an enormous body of data telling us that plant-rich diets are very healthy," says Josephine Briggs, head of the National Center for Complementary and Alternative Medicine, another NIH center. "As soon as we take these various antioxidants[and other nutrients] out and put them in a pill, we're not consistently getting a benefit."
Researchers and nutritionists are still recommending dietary supplements for the malnourished or people with certain nutrient deficiencies or medical conditions. For instance folic acid—the supplement form of folate——reduces the likelihood of a common birth defect if taken by pregnant women.
Studying the effects of vitamins and supplements in the real world is difficult, since people eat foods with multiple nutrients that can interact with supplements and skew results. And observational trials can only show an association, not cause and effect.
That is one reason the Council on Responsible Nutrition, which represents the supplement industry, says it is too early to say supplements don't have health benefits. Duffy MacKay, the group's vice president of regulatory and scientific affairs, says lengthier studies may be required to show the benefits of some supplements.
Micronutrients, which include antioxidants like vitamin C, hormones like vitamin D and metals like iron, are essential to the body in small amounts because they help facilitate important reactions in and between cells. Too much of them, however, can cause problems.
The effectiveness of many dietary supplements remains untested and makers aren't required to do tests before selling a product. Still, about half of Americans reported taking at least one supplement a month in 2006, in the National Health and Nutrition Examination Survey published in April of this year. The supplement industry brought in $28 billion in sales in 2010, up 4.4% from 2009, according to Nutrition Business Journal, an industry trade publication.
Vitamin users may derive a benefit from the placebo effect, experts say. And they often are convinced the supplements make them feel better, regardless of what studies show.
"The thing you do with [reports of studies] is just ride them out, and literally we see no impact on our business," said Joseph Fortunato, chief executive of supplement retailer GNC Corp., according to a transcript of the company's third-quarter conference call with analysts last week.
"Consumers believe in our products," a spokesman for GNC said. GNC's revenue grew 15.5% in the third quarter of this year compared to a year ago and the stock, which closed at $25.08, is up 0.5% year-to-date.
Of growing concern to many scientists are the increasing hints of harm from vitamins.
The first red flags started emerging nearly 20 years ago. Researchers thought from early work that extra beta-carotene could help prevent lung cancer, but two randomized trials published in 1994 and 1996 showed an increased rate of lung cancer among smokers who took beta-carotene supplements.
Oncologist Mark Heaney of Memorial Sloan-Kettering Cancer Center in New York showed in laboratory work in 2008 that vitamin C appeared to inhibit the effect of chemotherapy drugs for cancer treatment. Subsequent research has shown vitamin C may inadvertently protect cancer cells more than normal cells.
A study published this month in the Journal of the American Medical Association, known as the SELECT trial, found that vitamin E—previously thought to lower risk of prostate cancer—actually increased the chance slightly. The risk could be mitigated by the simultaneous consumption of another micronutrient, selenium, the study says.
Multivitamins aren't faring much better. Results from the Iowa Women's Health Study, published earlier this month in the Archives of Internal Medicine, found in a sample of over 38,000 older women, multivitamin use over time was linked with a slight but statistically significant increased risk of earlier mortality.
A studyof 1,900 men and women in 15 cities across Europe published in 2008 in the European Journal of Nutrition followed healthy elderly individuals for 10 years. Among smokers in the study, those who took multivitamins were more likely to die younger than smokers who didn't.
Another large trial examining postmenopausal women in the NIH's Women's Health Initiative found no discernible impact from taking a multivitamin on preventing breast, lung or colorectal cancer, cardiovascular disease or premature death, according to the 2009 study published in the Archives of Internal Medicine.
Some experts warn against overemphasizing the potential harm of multivitamins because it isn't clear how that statistical uptick in risk of death would translate into actual increased risk in real life.
The consistent failure to show benefits has led researchers at the National Center for Complementary and Alternative Medicine and elsewhere to call for more lab experiments and small-scale studies of how the nutrients work, after over a decade of pursuing large, clinical trials of particular supplements' effectiveness.
"We've missed a step," says Alan Kristal, a professor of epidemiology at the University of Washington who studies the links between diet and cancer. "We need to understand the mechanism by which these things are acting."
Roberta Anding, a nutritionist at Texas Children's Hospital in Houston, says some people need multivitamins and other supplements, but she is cautious about the risk from high doses of micronutrients. "It's no longer nutrition when the doses become high, it's pharmacology," she says.
The best way to get micronutrients is through a balanced diet, she says.
"If you're looking at this as, 'At least I'm [taking a multivitamin],' but you're not exercising or eating well, then it is a waste of money," says Ms. Anding, a spokeswoman for the American Dietetic Association, a research and advocacy group.
The data have prompted some nutrition researchers to say taking vitamins is a waste of money for those without a specific nutrient deficiency or chronic illness. Such findings have also fueled a debate about whether the field should continue conducting expensive human trials to figure out whether particular supplements affect health.
"The better the quality of the research, the less benefit [supplements] showed," says Marion Nestle, professor of nutrition, food studies, and public health at New York University. "It's fair to say from the research that supplements don't make healthy people healthier."
For instance, vitamins B-6 and B-12 are often touted as being good for the heart, but several studies have failed to find that they lower risk of cardiovascular disease, according the Office of Dietary Supplements, part of the National Institutes of Health. Vitamin C hasn't been shown in many studies to lower a person's risk of getting a cold. Calcium, while important to bone health, doesn't lower risk of heart disease or cancer and may increase risk of kidney stones.
"We have an enormous body of data telling us that plant-rich diets are very healthy," says Josephine Briggs, head of the National Center for Complementary and Alternative Medicine, another NIH center. "As soon as we take these various antioxidants[and other nutrients] out and put them in a pill, we're not consistently getting a benefit."
Researchers and nutritionists are still recommending dietary supplements for the malnourished or people with certain nutrient deficiencies or medical conditions. For instance folic acid—the supplement form of folate——reduces the likelihood of a common birth defect if taken by pregnant women.
Studying the effects of vitamins and supplements in the real world is difficult, since people eat foods with multiple nutrients that can interact with supplements and skew results. And observational trials can only show an association, not cause and effect.
That is one reason the Council on Responsible Nutrition, which represents the supplement industry, says it is too early to say supplements don't have health benefits. Duffy MacKay, the group's vice president of regulatory and scientific affairs, says lengthier studies may be required to show the benefits of some supplements.
Micronutrients, which include antioxidants like vitamin C, hormones like vitamin D and metals like iron, are essential to the body in small amounts because they help facilitate important reactions in and between cells. Too much of them, however, can cause problems.
The effectiveness of many dietary supplements remains untested and makers aren't required to do tests before selling a product. Still, about half of Americans reported taking at least one supplement a month in 2006, in the National Health and Nutrition Examination Survey published in April of this year. The supplement industry brought in $28 billion in sales in 2010, up 4.4% from 2009, according to Nutrition Business Journal, an industry trade publication.
Vitamin users may derive a benefit from the placebo effect, experts say. And they often are convinced the supplements make them feel better, regardless of what studies show.
"The thing you do with [reports of studies] is just ride them out, and literally we see no impact on our business," said Joseph Fortunato, chief executive of supplement retailer GNC Corp., according to a transcript of the company's third-quarter conference call with analysts last week.
"Consumers believe in our products," a spokesman for GNC said. GNC's revenue grew 15.5% in the third quarter of this year compared to a year ago and the stock, which closed at $25.08, is up 0.5% year-to-date.
Of growing concern to many scientists are the increasing hints of harm from vitamins.
The first red flags started emerging nearly 20 years ago. Researchers thought from early work that extra beta-carotene could help prevent lung cancer, but two randomized trials published in 1994 and 1996 showed an increased rate of lung cancer among smokers who took beta-carotene supplements.
Oncologist Mark Heaney of Memorial Sloan-Kettering Cancer Center in New York showed in laboratory work in 2008 that vitamin C appeared to inhibit the effect of chemotherapy drugs for cancer treatment. Subsequent research has shown vitamin C may inadvertently protect cancer cells more than normal cells.
A study published this month in the Journal of the American Medical Association, known as the SELECT trial, found that vitamin E—previously thought to lower risk of prostate cancer—actually increased the chance slightly. The risk could be mitigated by the simultaneous consumption of another micronutrient, selenium, the study says.
Multivitamins aren't faring much better. Results from the Iowa Women's Health Study, published earlier this month in the Archives of Internal Medicine, found in a sample of over 38,000 older women, multivitamin use over time was linked with a slight but statistically significant increased risk of earlier mortality.
A studyof 1,900 men and women in 15 cities across Europe published in 2008 in the European Journal of Nutrition followed healthy elderly individuals for 10 years. Among smokers in the study, those who took multivitamins were more likely to die younger than smokers who didn't.
Another large trial examining postmenopausal women in the NIH's Women's Health Initiative found no discernible impact from taking a multivitamin on preventing breast, lung or colorectal cancer, cardiovascular disease or premature death, according to the 2009 study published in the Archives of Internal Medicine.
Some experts warn against overemphasizing the potential harm of multivitamins because it isn't clear how that statistical uptick in risk of death would translate into actual increased risk in real life.
The consistent failure to show benefits has led researchers at the National Center for Complementary and Alternative Medicine and elsewhere to call for more lab experiments and small-scale studies of how the nutrients work, after over a decade of pursuing large, clinical trials of particular supplements' effectiveness.
"We've missed a step," says Alan Kristal, a professor of epidemiology at the University of Washington who studies the links between diet and cancer. "We need to understand the mechanism by which these things are acting."
Roberta Anding, a nutritionist at Texas Children's Hospital in Houston, says some people need multivitamins and other supplements, but she is cautious about the risk from high doses of micronutrients. "It's no longer nutrition when the doses become high, it's pharmacology," she says.
The best way to get micronutrients is through a balanced diet, she says.
"If you're looking at this as, 'At least I'm [taking a multivitamin],' but you're not exercising or eating well, then it is a waste of money," says Ms. Anding, a spokeswoman for the American Dietetic Association, a research and advocacy group.
2011年10月20日星期四
Abbott Northwestern patient left 'writhing in pain' sues
"Hi, love," Sarah May Casareto greeted Larry V. King as he lay on a gurney before surgery. As they wheeled down the hall, he recalled in court records, she told him that he'd have to "man up" because they couldn't give him a lot of medication.
The next 57 minutes of surgery were excruciating, according to a lawsuit filed Tuesday in Hennepin County District Court that accuses the drug-addicted former nurse of skimming his narcotics, which left him "writhing in pain" during a medical procedure for kidney stones last year at a Minneapolis hospital.
The lawsuit filed by King, a Carver County sheriff's deputy, follows the same scenario laid out by prosecutors who charged Casareto, 34, in February with felony theft of a controlled substance for allegedly stealing the powerful painkiller.
Casareto, of Forest Lake, entered an Alford plea of guilty Sept. 1 to a fifth-degree controlled substance crime for possessing Fentanyl, a high-powered painkiller, and was sentenced to probation in connection with the Nov. 8 incident at Abbott Northwestern Hospital. The plea enabled Casareto to maintain her innocence while acknowledging ample evidence to convict her.
The suit, which seeks at least $50,000 in damages, alleges that she was "negligent and careless" in her care for King, 57, of Bloomington. The suit also names Abbott as a defendant.
It contends that Abbott "knew or should have known [before the procedure] that Casareto was exhibiting drug-seeking behavior and that she had become dependent upon narcotic pain medications." It also notes that Abbott officials knew that she had failed "on at least six different occasions" to properly handle patients' pain medication obtained from the hospital pharmacy.
King's attorney, Tony Nemo, called the lawsuit reflective of "a growing problem" that should draw closer scrutiny to drug diversion, or the theft of medications intended for patients.
"One of the things I know Mr. King is hoping is that this case may cause Twin Cities hospitals to reveal procedures and protocols to, if not prevent, at least minimize this problem in the future," he said.
The Casareto case and others involving medical staffers have prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators in recent months to improve security measures. The new coalition hopes to recommend tougher controls early next year. State regulators say drug pilfering by doctors and nurses isn't new -- but the latest cases come with a disturbing wrinkle, leaving some patients in excruciating pain as they are robbed of needed medications. In the past year, seven nurses and aides have been caught stealing narcotics from hospitals and nursing homes across Minnesota to feed their own habits or to sell drugs on the street.
Casareto's attorney, Brian Toder, said Wednesday that he believes the lawsuit is no more valid than the criminal charges, which did not result in a conviction. Once Casareto's three years of probation is over, the case will be expunged from her record.
Hospital spokeswoman Gloria O'Connell declined to comment on the suit, saying, "We can't talk about pending litigation."
The suit did not name the surgeon, Dr. Subbarao Inampudi, as a defendant because he "began the procedure with the reasonable assumption that [Casareto] would follow his orders and administer" the painkiller as he directed, Nemo said Wednesday.
According to the lawsuit, King said that his doctor told him he would not likely feel pain during the procedure, and when King's pain was obvious, Inampudi repeatedly ordered Casareto, who struggled to stay awake and was rocking back and forth, to "get back to her patient and figure out why the pain medication was not working."
The next 57 minutes of surgery were excruciating, according to a lawsuit filed Tuesday in Hennepin County District Court that accuses the drug-addicted former nurse of skimming his narcotics, which left him "writhing in pain" during a medical procedure for kidney stones last year at a Minneapolis hospital.
The lawsuit filed by King, a Carver County sheriff's deputy, follows the same scenario laid out by prosecutors who charged Casareto, 34, in February with felony theft of a controlled substance for allegedly stealing the powerful painkiller.
Casareto, of Forest Lake, entered an Alford plea of guilty Sept. 1 to a fifth-degree controlled substance crime for possessing Fentanyl, a high-powered painkiller, and was sentenced to probation in connection with the Nov. 8 incident at Abbott Northwestern Hospital. The plea enabled Casareto to maintain her innocence while acknowledging ample evidence to convict her.
The suit, which seeks at least $50,000 in damages, alleges that she was "negligent and careless" in her care for King, 57, of Bloomington. The suit also names Abbott as a defendant.
It contends that Abbott "knew or should have known [before the procedure] that Casareto was exhibiting drug-seeking behavior and that she had become dependent upon narcotic pain medications." It also notes that Abbott officials knew that she had failed "on at least six different occasions" to properly handle patients' pain medication obtained from the hospital pharmacy.
King's attorney, Tony Nemo, called the lawsuit reflective of "a growing problem" that should draw closer scrutiny to drug diversion, or the theft of medications intended for patients.
"One of the things I know Mr. King is hoping is that this case may cause Twin Cities hospitals to reveal procedures and protocols to, if not prevent, at least minimize this problem in the future," he said.
The Casareto case and others involving medical staffers have prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators in recent months to improve security measures. The new coalition hopes to recommend tougher controls early next year. State regulators say drug pilfering by doctors and nurses isn't new -- but the latest cases come with a disturbing wrinkle, leaving some patients in excruciating pain as they are robbed of needed medications. In the past year, seven nurses and aides have been caught stealing narcotics from hospitals and nursing homes across Minnesota to feed their own habits or to sell drugs on the street.
Casareto's attorney, Brian Toder, said Wednesday that he believes the lawsuit is no more valid than the criminal charges, which did not result in a conviction. Once Casareto's three years of probation is over, the case will be expunged from her record.
Hospital spokeswoman Gloria O'Connell declined to comment on the suit, saying, "We can't talk about pending litigation."
The suit did not name the surgeon, Dr. Subbarao Inampudi, as a defendant because he "began the procedure with the reasonable assumption that [Casareto] would follow his orders and administer" the painkiller as he directed, Nemo said Wednesday.
According to the lawsuit, King said that his doctor told him he would not likely feel pain during the procedure, and when King's pain was obvious, Inampudi repeatedly ordered Casareto, who struggled to stay awake and was rocking back and forth, to "get back to her patient and figure out why the pain medication was not working."
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